Individual
JILL PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
175 FAIRVIEW LN, SONORA, CA 95370-4809
(209) 536-2000
Mailing address
4632 BAYVIEW DR, COPPEROPOLIS, CA 95228-9435
(701) 430-4013
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
18661
CA
225X00000X
Occupational Therapist
Primary
OT-1675
ID
Other
Enumeration date
04/24/2017
Last updated
03/19/2026
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